Breaking down fat: Use of freshly isolated SVF versus cultured ASC

by Alexey Bersenev on October 3, 2014 · 1 comment

in adipose

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We defined Stromal Vascular Fraction (SVF) – as cell fraction, freshly isolated from native adipose tissue or liposuction aspirates and Adipose-derived Stromal (stem) Cells (ASCs) as plastic adherent cell population, derived from SVF and propagated in culture. The big question in cell therapy is how to decide what to use SVF or ASC. There are many considerations for decision making, but most important the following:

  1. Experimental data, which support the preferential use of one cell product type versus another in particular indication;
  2. Availability of approved equipment, facilities, skilled personnel and funding;
  3. Clinical study settings: physician-led versus industry, indication;
  4. Regulatory requirements (permissive jurisdictions).

Interestingly, for adipose tissue cell-based therapies the most important factors are regulation and clinical study settings, but not supporting experimental data. Many physicians, working in “permissive jurisdictions” don’t even bother with experimental models, they just try SVF on patients. Ideally, well designed experimental models could solve dilemma “SVF versus ASC” or at least give a hint. A great example is a study from Bruce Bunnell’s lab, which compares SVF and ASC in experimental model of multiple sclerosis. However, some developers prefer to test both SVF and ASC in clinical trial settings.

I analyzed interest of adipose cell-based therapy developers to SVF versus ASC, based on registered clinical trials in international databases. First, I looked at total number of trials between 2011 and 2013, used SVF versus ASC:

SVF-ASC

As you can see from the graph – there is no preference for SVF or ASC.
Next, I looked at two most frequent groups of indications – musculoskeletal and cardiovascular diseases. Out of 14 cardiovascular trials, 7 used SVF (50%) – so, no preference. Out of 15 musculoskeletal trials, 10 used SVF (~66%) and 5 – ASC. So, clearly developers prefer SVF for musculoskeletal trials and equally open to SVF and ASC in cardiovascular trials.

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This post is a part of series Breaking Down Fat. In this series we will talk about identification, characterization and clinical processing of potentially therapeutic cell populations from adipose tissue. We started this series in response to the growing trend of wide (mostly uncontrolled) clinical use adipose-derived cells and some controversies/ misconceptions in the field.If you would like to contribute to this series or become a sponsor, please contact us!

{ 1 comment… read it below or add one }

Mike Hutchinson, DVM October 4, 2014 at 9:08 am

There are a lot of considerations why one might choose Adipose SVF or cultured ADSC’s for the experimental model. However, as I travel around the globe speaking to researchers and clinicians, I find the most common reason Adipose SVF is left out of discussions scientifically is the funding is biased toward allogeneic and xenogeneic studies (cultured ADSC’s) and not autologous studies. This understandably leaves the researchers (that have to spend an inordinate amount of time grant writing) applying for grants using cultured cell models. By definition, you cannot put autologous cells in a vial and sell it like a drug. You also cannot perform the typical blinded, placebo controlled studies using the same autologous cells in every patient. Since they are not standardized fractions (your SVF is different than my SVF), each patient is getting a different mixture in any trial that is being conducted. That in itself does not fit the standard research model that has been used for the last 50 years. Although, with the use of modern diagnostic tools we can easily use the individual as a control, it is frowned upon in the scientific community. As a likely result, clinicians are using autologous SVF with less scientific understanding.

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